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Dermatofibrosarcoma protuberans: Clinical diagnoses and treatment results of 260 cases in China
Author(s) -
Cai Hong,
Wang Yag,
Wu Jianghong,
Shi Yingqiang
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.22000
Subject(s) - dermatofibrosarcoma protuberans , medicine , medical diagnosis , dermatology , china , radiology , political science , law
Background and Objectives Dermatofibrosarcoma protuberans (DFSP) is a low‐grade malignant tumor but has high local recurrence rate. The objectives of this study were to analyze their clinicopathologic factors and review the experience of multidisciplinary treatments. Methods A total of 260 patients who were treated between 1985 and 2006 in Fudan University Shanghai Cancer Center were evaluated. Outcomes were compared focusing on recurrence and survival. Classical DFSP and transformed DFSP were the two subtypes. Results After local excision, 50.2% of the patients were found to have residual tumors. The recurrence rate after local excision was significantly higher than that after wide excision (45.0% vs. 8.5%, P < 0.0001). Patients undergoing wide excision with margins ≥3 cm were found to have lower recurrence rate compared with those margins 1.5–2.5 cm (5.7% vs. 13.6%, P = 0.043). Compared with classical DFSPs, transformed DFSPs had significantly higher recurrence rate (34.5% vs. 6.3%, P < 0.0001), higher metastatic rate (23.5% vs. 0.4%, P < 0.0001), and worse prognosis (10‐year survival rate 66.0% vs. 98.6%, P < 0.0001). Conclusions Performing adequate initial resection is important for patients with DFSP. Once DFSP was diagnosed, wide excision with a best margin of ≥3 cm is necessary. Transformed DFSPs are more aggressive tumors which need more energetic treatments. J. Surg. Oncol. 2012; 105:142–148. © 2011 Wiley Periodicals, Inc.